Sword Wendy, Jack Susan, Niccols Alison, Milligan Karen, Henderson Joanna, Thabane Lehana
School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Harm Reduct J. 2009 Nov 20;6:32. doi: 10.1186/1477-7517-6-32.
There is a need for services that effectively and comprehensively address the complex needs of women with substance use issues and their children. A growing body of literature supports the relevance of integrated treatment programs that offer a wide range of services in centralized settings. Quantitative studies suggest that these programs are associated with positive outcomes. A qualitative meta-synthesis was conducted to provide insight into the processes that contribute to recovery in integrated programs and women's perceptions of benefits for themselves and their children.
A comprehensive search of published and unpublished literature to August 2009 was carried out for narrative reports of women's experiences and perceptions of integrated treatment programs. Eligibility for inclusion in the meta-synthesis was determined using defined criteria. Quality assessment was then conducted. Qualitative data and interpretations were extracted from studies of adequate quality, and were synthesized using a systematic and iterative process to create themes and overarching concepts.
A total of 15 documents were included in the meta-synthesis. Women experienced a number of psychosocial processes during treatment that played a role in their recovery and contributed to favourable outcomes. These included: development of a sense of self; development of personal agency; giving and receiving of social support; engagement with program staff; self-disclosure of challenges, feelings, and past experiences; recognizing patterns of destructive behaviour; and goal setting. A final process, the motivating presence of children, sustained women in their recovery journeys. Perceived outcomes included benefits for maternal and child well-being, and enhanced parenting capacity.
A number of distinct but interconnected processes emerged as being important to women's addiction recovery. Women experienced individual growth and transformative learning that led to a higher quality of life and improved interactions with their children. The findings support the need for programs to adopt practices that focus on improving maternal health and social functioning in an environment characterized by empowerment, safety, and connections. Women's relationships with their children require particular attention as positive parenting practices and family relationships can alter predispositions toward substance use later in life, thereby impacting favourably on the cycle of addiction and dysfunctional parenting.
需要有能有效且全面满足有药物使用问题的女性及其子女复杂需求的服务。越来越多的文献支持在集中场所提供广泛服务的综合治疗项目的相关性。定量研究表明这些项目与积极成果相关。进行了一项定性元分析，以深入了解综合项目中有助于康复的过程以及女性对自身及其子女所获益处的看法。
对截至2009年8月已发表和未发表的文献进行全面检索，查找关于女性对综合治疗项目的经历和看法的叙述性报告。使用既定标准确定纳入元分析的资格。然后进行质量评估。从质量足够的研究中提取定性数据和解释，并使用系统且反复的过程进行综合，以创建主题和总体概念。
元分析共纳入15份文献。女性在治疗期间经历了一些心理社会过程，这些过程在她们的康复中发挥了作用并促成了良好结果。这些过程包括：自我意识的发展；个人能动性的发展；给予和接受社会支持；与项目工作人员的互动；挑战、感受和过往经历的自我表露；认识到破坏性行为模式；以及目标设定。最后一个过程，即孩子的激励作用，使女性在康复之路上坚持不懈。感知到的结果包括对母婴福祉的益处以及育儿能力的增强。
一些独特但相互关联的过程对女性成瘾康复很重要。女性经历了个人成长和变革性学习，从而带来更高的生活质量并改善了与子女的互动。研究结果支持项目需要采用注重在赋权、安全和联系的环境中改善孕产妇健康和社会功能的做法。女性与其子女的关系需要特别关注，因为积极的育儿做法和家庭关系可以改变日后对药物使用的倾向，从而对成瘾和功能失调育儿的循环产生有利影响。
